Limits...
Schistosomiasis in pre-school-age children and their mothers in Chikhwawa district, Malawi with notes on characterization of schistosomes and snails.

Poole H, Terlouw DJ, Naunje A, Mzembe K, Stanton M, Betson M, Lalloo DG, Stothard JR - Parasit Vectors (2014)

Bottom Line: PSAC often had extensive daily water contact and many (~25%) had haematuria and albuminuria.As eggs with an atypical morphology of Schistosoma haematobium were observed, a general selection of schistosome eggs was characterized by DNA barcoding, finding Group I S. haematobium and Group IV and V S. mansoni.Malacological surveys encountered several populations of Bulinus globosus but failed to find Biomphalaria.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. r.stothard@liv.ac.uk.

ABSTRACT

Background: To complement ongoing schistosomiasis control within national control programmes (NCPs) that administer praziquantel to school-age children, assessing the risk and extent of schistosomiasis in pre-school-age children (PSAC) is important.

Methods: In June 2012, schistosomiasis in Chikhwawa district, Malawi was assessed across 12 villages examining pre-school-age children (PSAC) and their mothers by serological and parasitological diagnosis, as supplemented with urine-antigen and questionnaire-interview methods. Urinary tract morbidity was inferred by haematuria and albuminuria assays.

Results: In total, 49.5% (CI₉₅ 42.6-56.4) of 208 PSAC and 94.5% (CI₉₅ 90.9-98.1) of 165 mothers were seropositive for schistosomiasis, in 2 villages seroprevalence exceeded 75% in PSAC. Egg-patent urogenital and intestinal schistosomiasis was observed; 17.7% (CI₉₅ 12.4-23.2) of PSAC and 45.1% (CI₉₅ 37.4-52.8) of mothers having active schistosomiasis by parasitological and urine-antigen testing combined. PSAC often had extensive daily water contact and many (~25%) had haematuria and albuminuria. As eggs with an atypical morphology of Schistosoma haematobium were observed, a general selection of schistosome eggs was characterized by DNA barcoding, finding Group I S. haematobium and Group IV and V S. mansoni. Malacological surveys encountered several populations of Bulinus globosus but failed to find Biomphalaria.

Conclusions: Both PSAC and their mothers appear to be at significant risk of schistosomiasis and should be considered for treatment within the NCP of Malawi.

Show MeSH

Related in: MedlinePlus

Prevalence of schistosomiasis as assessed by different diagnostic methodologies in PSAC and mothers across the 12 villages [CI95 around the prevalence are indicated].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4230191&req=5

Figure 3: Prevalence of schistosomiasis as assessed by different diagnostic methodologies in PSAC and mothers across the 12 villages [CI95 around the prevalence are indicated].

Mentions: Pooling of positive results from all three techniques (stool & urine examination, CCA-dipsticks and SEA-ELISA) demonstrated an overall prevalence of 53.9% (CI95 47.0-60.9) in PSAC (Figure 3). As children are seronegative for schistosomiasis until they acquire their first infection, the SEA-ELISA can be considered the most sensitive method for detection of initial active infection but cannot differentiate between the two forms of schistosomiasis and might time-lag slightly behind urine-antigen methods. Urine-CCA dipsticks are considered to be excellent proxy markers of intestinal schistosomiasis and are not confounded in this instance by urogenital schistosomiasis. The prevalence of co-infection with both S. haematobium and S. mansoni was estimated to be 8.5% in mothers (CI95 4.2-12.8) and 3.6% in children (CI95 1.0-6.2) using criteria of a positive CCA-dipstick (S. mansoni) and urine-filtration/microhaematuria (S. haematobium).


Schistosomiasis in pre-school-age children and their mothers in Chikhwawa district, Malawi with notes on characterization of schistosomes and snails.

Poole H, Terlouw DJ, Naunje A, Mzembe K, Stanton M, Betson M, Lalloo DG, Stothard JR - Parasit Vectors (2014)

Prevalence of schistosomiasis as assessed by different diagnostic methodologies in PSAC and mothers across the 12 villages [CI95 around the prevalence are indicated].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230191&req=5

Figure 3: Prevalence of schistosomiasis as assessed by different diagnostic methodologies in PSAC and mothers across the 12 villages [CI95 around the prevalence are indicated].
Mentions: Pooling of positive results from all three techniques (stool & urine examination, CCA-dipsticks and SEA-ELISA) demonstrated an overall prevalence of 53.9% (CI95 47.0-60.9) in PSAC (Figure 3). As children are seronegative for schistosomiasis until they acquire their first infection, the SEA-ELISA can be considered the most sensitive method for detection of initial active infection but cannot differentiate between the two forms of schistosomiasis and might time-lag slightly behind urine-antigen methods. Urine-CCA dipsticks are considered to be excellent proxy markers of intestinal schistosomiasis and are not confounded in this instance by urogenital schistosomiasis. The prevalence of co-infection with both S. haematobium and S. mansoni was estimated to be 8.5% in mothers (CI95 4.2-12.8) and 3.6% in children (CI95 1.0-6.2) using criteria of a positive CCA-dipstick (S. mansoni) and urine-filtration/microhaematuria (S. haematobium).

Bottom Line: PSAC often had extensive daily water contact and many (~25%) had haematuria and albuminuria.As eggs with an atypical morphology of Schistosoma haematobium were observed, a general selection of schistosome eggs was characterized by DNA barcoding, finding Group I S. haematobium and Group IV and V S. mansoni.Malacological surveys encountered several populations of Bulinus globosus but failed to find Biomphalaria.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. r.stothard@liv.ac.uk.

ABSTRACT

Background: To complement ongoing schistosomiasis control within national control programmes (NCPs) that administer praziquantel to school-age children, assessing the risk and extent of schistosomiasis in pre-school-age children (PSAC) is important.

Methods: In June 2012, schistosomiasis in Chikhwawa district, Malawi was assessed across 12 villages examining pre-school-age children (PSAC) and their mothers by serological and parasitological diagnosis, as supplemented with urine-antigen and questionnaire-interview methods. Urinary tract morbidity was inferred by haematuria and albuminuria assays.

Results: In total, 49.5% (CI₉₅ 42.6-56.4) of 208 PSAC and 94.5% (CI₉₅ 90.9-98.1) of 165 mothers were seropositive for schistosomiasis, in 2 villages seroprevalence exceeded 75% in PSAC. Egg-patent urogenital and intestinal schistosomiasis was observed; 17.7% (CI₉₅ 12.4-23.2) of PSAC and 45.1% (CI₉₅ 37.4-52.8) of mothers having active schistosomiasis by parasitological and urine-antigen testing combined. PSAC often had extensive daily water contact and many (~25%) had haematuria and albuminuria. As eggs with an atypical morphology of Schistosoma haematobium were observed, a general selection of schistosome eggs was characterized by DNA barcoding, finding Group I S. haematobium and Group IV and V S. mansoni. Malacological surveys encountered several populations of Bulinus globosus but failed to find Biomphalaria.

Conclusions: Both PSAC and their mothers appear to be at significant risk of schistosomiasis and should be considered for treatment within the NCP of Malawi.

Show MeSH
Related in: MedlinePlus